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This really creams my corn!

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I went to the doctor recently.

Nothing worrisome, just my annual physical. I’m ridiculously healthy for my age and though I have a bad knee, bunions and the normal aches and pains associated with reaching my sixth decade… there were thankfully no major issues to discuss.

I don’t have diabetes, or high cholesterol or any other ailments that require medication so my annual wellness check is usually a quick in and out with a stamp of good health.

We have excellent insurance due to my husband’s military service and my visit is always completely covered.

Free.

Until the other day when I received this bill.

.

.

It showed a $25 balance and while that certainly wasn’t a problem…. it was different, and made me wonder what had changed.

Not being able to decipher the coded language on the bill, I did some research.

Turns out I’m too healthy.

.

.

I’m being penalized because I’m healthy?

The doctor didn’t have to make any medical decisions.

So they charge me more?

What the utter hell is that about!

😡

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44 thoughts on “This really creams my corn!”

  2. They get you one way or another!

    After surviving my Sudden Cardaic Arrest a couple of years ago, my insurance company refused to pay out on a Critical Illness policy. I mean, how ‘critical’ do they want it? Seems I was unwell, but not unwell enough to claim … and I was dead, but not dead enough for my Life policy to kick in.

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  3. No. Actually, the code for a higher level of decision-making results in a higher charge.

    “Better” yet is that providers are now often limited in the number of routine physicals they’re allowed to do. The company doesn’t make enough off of them. If you have a problem, they can bill for the problem. So if you go in for a physical and bring up your bunion, your knee, and another ache, that’s three different problems with three different billing codes, all of which can then be charged during a single visit.

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    1. Seriously? I was with her for maybe 10 minutes, tops. A few years ago an annual physical meant just that, a full exam. Now they just sit at the computer and ask a few questions. And I didn’t even bring up my knee or bunions so I don’t know what extra decisions she had to make.

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      1. Yep. A short visit with few problems gets coded as “low complexity”, which is the cheapest. My last “physical” included listening to my lungs and heart, but no palpation of abdominal organs, which used to be part of every physical. Shorter, more cursory, more expensive…As AutumAshbough notes, we have an insurance industry in lieu of a healthcare system. I was charged an “operating room fee” for a brief procedure while fully clothed in a carpeted office. Didn’t look like an operating room to me.

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    1. We’re very blessed to have wonderful health care coverage, and I’m certainly not complaining about the $25, but rather the reason for the charge.
      Our costs have gone up considerably on prescription drugs, which my husband takes a multitude of. A few years ago co pays were $4, his last one was $100. That’s a big jump.
      I never understand why other countries seem to do it better.

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  5. Well that sucks monkey balls! I agree with CeeTee, they try and get you one way or the other. You for being healthy, for not needing four thousand pills to take (like me) so they charge for their time?!?! That’s just bull crap!

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  6. Here in Canada I don’t do annual physical exams anymore because they seem useless. The doctor barely looks at me, too busy talking at the screen asking me questions and then typing them in.

    Instead however, he makes a million recommendations. Go get this checked out and that checked out: mammogram, pap smear, cervical test…

    Those are of course all billable which here in Ontario are covered under OHIP. But that goes back to each medical entity, meaning they get paid by the provincial insurance.

    But, since I get mammogram and cervical test reminders anyway even if I don’t go to an annual exam, why sit in a doctor’s office for about 10 minutes? Seems to me his time is better served in dealing with someone who needs medical attention for a pressing or urgent situations.

    But I don’t know. For now I’m not worried about it. I think you’re right to investigate, especially when it happens in the sneaky way it just showed up on the bill with no plausible explanation.

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    1. Honestly, I wouldn’t go at all but I’m on one little low dose pill for my blood pressure and if I don’t go at least once a year they don’t refill it. And yes, she wanted me to have a colonoscopy, a mammogram, a bone density test and a flu shot. I said no thanks to all.

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  9. That’s a new one on me. We’ve had some goofy medical bills in the past. Many, many moons ago we got sent to collections on a bill we didn’t even know about. The doctor made zero attempts to collect from us – they just flipped it to a third-party collection service. Easily resolved, but after that nothing ever surprised us when it came to medical billing.

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      3. He was attacked by a stray rottie with no owner. He called the County Health Department because he read rabies shots were ridiculously expensive. The County wrote him a letter saying they required the shots because they had several cases of rabies in dogs lately, and couldn’t locate this dog to check for rabies. That letter got his insurance to cover most of the bill. The only place to get rabies shots these days are ERs at major hospitals.

        My son said the first shot was in the wound and was Rabies immunoglobulin. They poked him five times in the wound and filled it with a syringe with the diameter of a nickel and a needle the size of a sewing machine needle! After that he have five more shots over the week that were normal.

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  13. Yeah, the scary part is the “Insurance adjustment” part, followed by “insurance paid”. So, does this mean the insurance company gets a 55% price break, and if you didn’t have insurance, the full price would kick in? Well, we just answered part 5 of the question “What is broken with our medical system?”

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  17. Now this one I know. Since Obama care, there has been a change in charges for a unneeded visit. It enables the insurance companies to make some money back with all of the cuts to cost of everything involved since the changes. Next time tell them you have a headache LOL

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